Glasses-free 3D versus 2D video-assisted thoracoscopic thymectomy: a single-center short-term comparative study

Thymectomy is commonly applied for the treatment of thymomas, thymic cysts, thymic adenocarcinomas, and other thymic diseases, as well as to control the symptoms of myasthenia gravis (1). Along with the development of surgical technologies, methods used for thymectomy have been vastly improved. As compared with traditional median sternotomy, the invasiveness and perioperative complications of video-assisted thoracoscopic surgery (VATS) thymectomy are greatly reduced for the treatment of myasthenia gravis and anterior mediastinal tumors, while safety and practicability have been significantly improved (2). Meanwhile, VATS-related equipment has evolved from the traditional two-dimensional (2D) thoracoscope to a three-dimensional (3D) head-mounted thoracoscope with the use of glasses. Although a pair of polarized 3D glasses is needed to obtain stereo images, many surgeons complain of becoming tired and dizzy while wearing protracted 3D glasses and have reported switching between different visual channels when interacting with off-screen environments. In addition, black glasses can reduce the brightness of the screen, although exhaling creates fog, which affects the view of the screen. On May 5, 2015, glasses-free 3D thoracoscopy was applied for the first time in our center for the treatment of a patient with lung cancer (3). This method was found to safe for radical lung cancer surgery, even complex radical resection of pulmonary carcinoma (4), and can significantly shorten the duration of mediastinal lymph node dissection as compared that of 2D thoracoscopic surgery (5). However, for patients undergoing thymectomy, there is still no relevant report on the comparison of glasses-free 3D thoracoscopy with traditional 2D thoracoscopy. Therefore, the aim of the present study was to compare the outcomes of glasses-free 3D versus 2D VATS to assess the advantages of glasses-free 3D thoracoscopic surgery for thymectomy